Healthcare Provider Details

I. General information

NPI: 1144165283
Provider Name (Legal Business Name): NIVETHITHA NAGARAJAN BDS, MDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PARNASSUS AVE FL 7
SAN FRANCISCO CA
94143-2205
US

IV. Provider business mailing address

2130 POST ST APT 203
SAN FRANCISCO CA
94115-3558
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-2045
  • Fax:
Mailing address:
  • Phone: 408-398-2265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code125Q00000X
TaxonomyOral Medicine Dentistry
License NumberNA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: